UAB Synopsis, Vol. 26, No. 24, July 2, 2007

“UAB is in its 15th year of stereotactic radiosurgery, and our experience clearly demonstrates focused radiation is appropriate for cancers in the spine, lung, and liver, as well as for cranial tumors,” says UAB neurosurgeon and Gamma Knife Medical Director Barton L. Guthrie, MD. His colleague, radiation oncologist John B. Fiveash, MD, notes, “We are shortening treatment times and dramatically advancing the accuracy of radiation delivery.”

The Gamma Knife, the most commonly used instrument to deliver cranial stereotactic radiosurgery, “is as effective as open surgery for local control of metastases from melanoma, lung cancer, and breast cancer,” Dr. Guthrie says.

The Gamma Knife’s minimally invasive approach eliminates risks associated with open surgery, minimizes risk of brain damage, shortens procedure time and hospital stays, and allows patients to keep their hair.

After a 10-year partnership with Health-South, UAB is now the sole owner of Alabama’s only Gamma Knife, which is located at UAB Highlands. UAB physicians have performed nearly 3100 radiosurgery procedures with the Gamma Knife since 1995.

Gamma Knife Applications
Tumors (including metastases, meningioma, acoustic, and pituitary) make up 75% of the Gamma Knife’s caseload. “The device also benefits individuals with arteriovenous malformations, which account for about 10% of our surgeries, and functional trigeminal neuralgia, which accounts for about 16% of surgeries, Dr. Guthrie says. “In addition, it is an effective tool used in conjunction with standard surgery. Gamma Knife follow-up enhances surgical management of lesions greater than 3 cm and preserves normal brain tissue,” he says.

UAB neurosurgeons, radiation oncologists, and physicists consult to determine an appropriate treatment plan. A lightweight aluminum frame fixed to the patient’s skull immobilizes the head and guides delivery of 201 gamma rays to a specific treatment focal point in the skull. Computerized tomography allows the clinical team to target the treatment area with precision. The delivery of radiation typically lasts from 30 to 90 minutes.

“The Gamma Knife offers a better treatment option for a significant number of neurological conditions previously considered surgical, and it improves management of surgically difficult tumors when used in combination with traditional surgery,” Dr. Guthrie says. “It has become an indispensable resource in the neurosurgical management of a variety of intracranial maladies.”